Claims Been in a vehicle accident?

Three step process:

  1. Report your accident to Police
  2. Notify the approved CTP Insurer of the motor vehicle by completing an Accident Report Form
    If you are not too sure who that is contact the CTP Insurance Regulator for more information
  3. If you intend to make a claim, complete the required forms

Report to Police immediately

If you have been in a crash, it is important that you report it to Police within 24 hours. If your motor vehicle is damaged, contact your motor vehicle insurer (if any) in respect of that damage.

You can report certain crashes online instead of reporting the collision at a Police station. While drivers are still required by law to report crashes involving death or injury to Police within 90 minutes of the accident, other crashes may now be reported online, particularly those where no one has been injured and that involve less than $3,000 worth of damage. To report a crash online and to understand the report criteria, visit South Australia Police's Report a crash page.

Notification of Insurer

If you are the owner, person in charge of or driver of a motor vehicle that is involved in a crash resulting in the death of, or bodily injury to, a person, you must notify the insurer of the motor vehicle as soon as practicable, by completing and submitting an Accident Report Form.

Medical assistance

If you have any pain, discomfort or injuries you should seek medical advice.

To claim or not claim?

If the crash was not your fault or you are a child under the age of 16, you may be entitled to make a CTP Insurance claim for personal injury compensation. This can be done by contacting the Regulator in the first instance.

If you have been in a crash and are deemed to be more than 25% responsible, you will be liable to pay an excess should someone lodge an injury claim in relation to the crash.

Can I make a CTP Insurance claim?

If you or your child has been injured in a crash where a South Australian registered motor vehicle was at fault, the South Australian CTP Insurance scheme provides compensation to you for your injuries (subject to eligibility criteria being met).

Passenger or driver?

If you were injured as a passenger in a crash that involved only the motor vehicle you were travelling in (or ‘on’ in the case of a motorcycle or scooter), then you may be entitled to make a claim if the driver/rider was at fault. That driver or rider may not be entitled to make a claim against the CTP Insurance scheme if they were at fault.

Unknown or uninsured vehicle

If the motor vehicle involved in the crash is unknown or uninsured for CTP Insurance purposes, you may have a claim against the Nominal Defendant Scheme. There are certain criteria that must be met to qualify for this compensation, so please talk to the Regulator for more information.

Support for injured children

The CTP Insurance scheme also provides coverage for the necessary and reasonable treatment, care and support needs of children under the age of 16 injured in a crash which occurred in South Australia on or after 1 July 2013. That coverage is available regardless of whether the child, a South Australian registered motor vehicle or an interstate registered vehicle was at fault. If an unknown or uninsured vehicle was involved, the Nominal Defendant Scheme will be liable for those expenses.

Lifetime Support Scheme for serious injuries

If you sustained serious injuries in a motor vehicle accident, which occurred in South Australia on or after 1 July 2014 you may be entitled to necessary and reasonable treatment, care and support under the Lifetime Support Scheme (LSS). Eligibility is determined by your injury, regardless of whether you or a South Australian registered motor vehicle were at fault and regardless of your age. Your application for LSS support will be dealt with by the Lifetime Support Authority and is not part of your CTP Insurance claim.

How do I make a CTP Insurance claim?

If you were injured as a result of a crash, the first thing you should do is report it to the Police.

Approved insurer

If you are unaware of who your allocated CTP insurer is, you can easily find out the insurer of your own or another vehicle by using the below EzyReg services and entering the vehicle registration number:

  • online at EzyReg - select the 'Check registration expiry date' option
  • by EzyReg smartphone app available for both iPhone and Android

Alternatively, please contact the CTP Insurance Enquiries Line on 1300 303 558.

Once you have lodged a claim form with the CTP Insurance Regulator or approved insurer, a claims consultant from the approved insurer that will be managing the claim will then make contact with you to talk about your claim and ask you for any more information that may be needed.

Under the Motor Vehicles Act 1959, as part of your Injury Claim Form or Fatality Claim Form, the forms include authorisation for the insurer to obtain documentary information relevant to your claim.

The approved insurer or claims agent must provide you with a copy of any documents that they obtain within 21 days of receipt.

Timeframes also apply when making a CTP Insurance claim. You must lodge an Injury Claim Form (or Fatality Claim Form in the event that your claim relates to the death of a person in a motor vehicle accident):

  • As soon as reasonably practicable if the motor vehicle that caused the crash is unknown or uninsured.
  • Within six months of the motor vehicle accident in any other circumstance.

If you have not complied with these timeframes please contact your approved insurer to discuss your circumstances.

If you have not received these forms already, they are available here or you can have them posted to you by phoning the CTP Insurance Support Helpline.

Medical assistance

If you have long term or serious injuries, it is important to continue seeing your doctor or specialist so:

  • Your recovery is optimised
  • The insurer handling your claim can obtain medical reports about your progress
  • The insurer handling your claim can consider the ongoing approval and payment for your treatment.
What information am I required to give as part of the CTP Insurance claim process?

The more information you can supply, the easier it will be for the insurer handling your claim to process your CTP Insurance claim.

The information you are required to provide will depend on the compensation you are seeking. As a starting point, you are required to complete an Injury Claim Form or Fatality Claim Form.

Required information

Some of the information the Injury Claim Form and the Fatality Claim Form will ask you to provide includes:

  • Proof of identity.
  • The facts of the crash.
  • Details of the vehicles you think caused the accident.
  • The time and place at which it occurred.
  • The circumstances of the crash.
  • The name, date of birth and address of the driver of the motor vehicle at the time of the crash.
  • The name and address of any person killed or injured in the crash, if known.
  • The details of any witnesses of the crash, if known.
  • A medical certificate or opinion as to the nature and probable cause of your injuries.
  • The relevant police report number for any report provided to a police officer in connection with the crash.
  • Evidence of income and/or copies of treatment accounts, if relevant.

Note: If you are the owner, person in charge or the driver of a motor vehicle involved in a crash, the law requires you to co-operate fully with your approved insurer in providing the information required to process any claim. Penalties apply if this is not done (Section 124 of the Motor Vehicles Act 1959).

Who is unable to make a CTP Insurance claim?

You are unable to make a CTP Insurance claim in South Australia if:

  • You were not injured in the crash and want to claim for motor vehicle damage (please contact your relevant car insurance company).
  • The motor vehicle you were driving was the only motor vehicle involved in the crash and no one else was at fault (unless you meet the requirements stated above for children or for the Lifetime Support Scheme).
  • You were injured in a crash and the motor vehicle at fault was registered and insured by a CTP insurance insurer in another state or territory – even if the crash occurred in South Australia (unless you meet the requirements stated above for children). You may be able to make a claim with the relevant CTP insurance scheme in the State where the motor vehicle at fault is registered. Alternatively, you may qualify for the Lifetime Support Scheme.
If you are at fault?

If you are deemed to be more than 25% responsible for a crash where someone was injured and have paid your CTP Insurance premium (via your registration) you will be required to pay an excess.

You will be required to complete an Accident Report Form and return it to the approved insurer of the motor vehicle.

There are also a number of circumstances which may permit your insurer to recover from you the CTP Insurance compensation paid by them to the injured person. These circumstances include if you:

  • Drove an unregistered vehicle.
  • Were under the influence of alcohol or drugs.
  • Were speeding or driving dangerously.
  • Intentionally caused injury.
  • Drove a vehicle without the owner’s permission.
  • Don’t hold a current driver’s licence.
  • Drove an unroadworthy or overloaded vehicle.

The money recovered from you may include injury compensation and claims management costs. This can amount to many thousands of dollars.

Need help with an existing claim?

If you have an existing CTP Insurance claim which was made prior to 30 June 2016, please phone Allianz SA CTP (The Motor Accident Commission’s claims manager) on 1300 618 389.

If you have an existing claim which was made after 1 July 2016 and would like information about its progress, please phone the approved insurer that is managing your claim, or the CTP Insurance Regulator if you are unsure which insurer is managing your claim.

Should you wish to make a complaint, in the first instance you should contact your approved insurer.

If the issue cannot be resolved or you are not satisfied with the outcome you may wish to contact the CTP Insurance Support Helpline.

Legal Representation

Approved Insurers have a responsibility to connect directly with you about your injury claim as quickly as possible, in a fair and efficient manner in accordance with the law under the Regulator's Rules.

Also you are able to seek your own legal advice at any stage of your injury claim process. If you decide to engage a lawyer, there are limits to the amount of legal costs the CTP approved insurer is required to pay.

If the total amount of compensation paid to you by the CTP insurer for your claim does not exceed $25,000, no legal fees (including disbursements incurred by the lawyer in acting on your behalf such as Court filing fees, investigation enquiries, expert medical reports and photocopying) are recoverable and you may be responsible to pay some or all of your legal costs. Limitations also apply if your compensation exceeds $25,000.

There will always be a component of any legal fees that will not be claimable from your insurer. Prior to engaging a lawyer you should discuss with them:

  • the nature of the work expected to be undertaken
  • how you will be charged, including billing methods, expected periodic review of costs incurred and any additional fees or costs
  • an estimate of likely legal costs.

Your lawyer is obliged to provide you with this information in writing. Further information can be obtained on the Law Society website under Legal Costs where you will find information on Your Right to Know, Your Right to Challenge Legal Costs and Costs Disclosure.

The Law Society of South Australia can also provide you with further information and details of Legal Practitioners who practice in personal injury cases and who can provide legal advice.

What will CTP Insurance compensation cover me for?

The Scheme provides compensation for necessary and reasonable hospital, medical and other treatment costs. These include (but are not limited to) the following costs:

  • Medical treatment
  • Medications
  • Ambulance
  • Hospital
  • Physiotherapy
  • Chiropractic

Treatment requirements

Please note that not all types of health care, therapy and support services are covered by the CTP Insurance scheme. It is best to contact your approved insurer and discuss your treatment requirements with your claims consultant before undertaking alternative treatments. Generally, all providers of medical and allied health services must be appropriately qualified for your expenses to be covered by the CTP Insurance scheme.

Compensation

In addition to immediate health care and treatment costs, compensation may also cover the items listed below.

  • An allowance for any non-economic loss (pain and suffering) experienced by you as a result of your injuries.
  • Loss of earning capacity (past and future), excluding the first week’s loss.
  • Future treatment and care requirements.
  • Travel expenses to and from treatment.
  • An allowance for any homecare and personal care services you may require as a result of your injuries (e.g. cleaning and gardening).

These payments are only made for claims in certain circumstances where fault has been established on the part of a South Australian registered motor vehicle or where you qualify for compensation under the Nominal Defendant Scheme. There are a number of legal requirements that must be met before these payments are made, which include satisfying certain thresholds determined by the seriousness of your injury. For example, your entitlement to damages for non-economic loss must meet a threshold based on an Injury Scale Value (ISV) reflecting the severity of the injuries sustained that assigns a value between a range of 0 and 100. The ISV range aligns to a monetary sum that represents the amount of damages for a fixed sum of compensation for the compensable injury. The table of ISVs is available here.

How does the CTP approved insurer make decisions about my claim?

To process your claim, the approved insurer must investigate liability (who is at fault in the road crash and to what degree) and the amount of compensation to be paid.

In many cases, these investigations can be complex and can therefore take some time. Decisions about liability are based on legislation, court precedents and outcomes.

Your CTP insurer may also refer to legislation such as the Motor Vehicles Act 1959 and the Civil Liability Act 1936.

How long will it take to process my claim?

As the circumstances of each claim are often different, it is difficult to provide an exact timeframe for the settlement of your claim. The timeframe will depend on the complexity of your injuries and the circumstances of the crash.

Providing your approved insurer with detailed and accurate information about the crash, your injuries and medical condition promptly will assist the insurer to process your claim as quickly and efficiently as possible.

Subject to eligibility being met, there are six key steps in processing a CTP claim:

  1. Submit an Injury Claim Form or Fatality Claim Form to the approved insurer of the vehicle you believe to be most ‘at fault’ in the accident. If you are unsure of who the ‘at fault’ approved insurer is, contact the Regulator.
  2. Once your claim form has been allocated, the approved insurer will issue a claim number and appoint a claims consultant to your case.
  3. The approved insurer claims consultant contacts parties involved in the crash.
  4. The approved insurer will investigate who was at fault in the crash based on, for example, Accident Reports, police reports and other investigations.
  5. The approved insurer collects medical information and monitors your treatment. The insurer may pay some accounts prior to final settlement being reached.
  6. Once your injury has stabilised, the approved insurer will proceed to finalise your claim. Before your claim can be settled it must also be determined if you qualify for any compensation so that the approved insurer can determine a final amount that is appropriate.

This needs to be confirmed by medical and other evidence about any loss sustained as a result of injuries caused by or arising out of the crash. An offer of settlement will be made either directly to you, or if you are legally represented, to your representative.

If you have questions or concerns about the offer of settlement, they can be discussed with your claims consultant, or if you are legally represented, with your representative. Once settlement has been agreed the appropriate documents will be sent to you for your signature.

Your approved insurer is legally obligated to contact Medicare Australia and other statutory authorities such as Centrelink and advise them of the settlement to be paid. These organisations may require reimbursement of amounts paid to you as a result of the claim. These amounts will be deducted from your settlement payment.

Injury Scale Value (ISV) Medical Assessments

In the CTP Insurance scheme, a person who is injured in a motor vehicle accident may be entitled to compensation for their injuries. Under Section 76 of the Civil Liability Act, the designated Minister has established an accreditation scheme called the Motor Accident Injury Assessment Scheme (MAIAS) to accredit Health Professionals for the purpose of undertaking assessments (ISV Medical Assessments) to assist in determining an injured person’s entitlement to compensation for accidents which occur on or after 1 July 2013. The ISV table is available here.

The Motor Accident Injury Assessment Scheme will accredit medical practitioners (general and specialist) to undertake ISV Medical Assessments, comprising of a whole person impairment assessment and allocation of an ISV.

For further information about the Accreditation Scheme visit MAIAS.

Lifetime Support Scheme (LSS)

What is the LSS?

The Lifetime Support Scheme (LSS) is a no fault scheme which provides necessary and reasonable treatment, care and support for people who sustain serious lifelong injuries in a crash. The Lifetime Support Authority (LSA) administers the LSS.

The LSS applies to crashes which occur in South Australia on or after 1 July 2014.

As a no fault scheme, the LSS is able to support people with serious lifetime injuries, who were previously only eligible to seek compensation if there was someone else at fault in the crash.

It means that drivers who sustain lifelong injuries in single motor vehicle crashes can now receive necessary and reasonable treatment, care and support, which was previously not available to them.

Who is eligible for the LSS?

If you have sustained a very serious spinal or brain injury, whole limb or multiple amputations, major burns or blindness, you may qualify for support under the LSS. The eligibility criteria to assess whether lifetime support is required are outlined in the LSS Rules.

Fraud

Please report motor injury fraud. After all you’re paying for it.

People who make false motor injury claims rip millions of dollars off South Australian motorists every year. Selfish people, who stage crashes, exaggerate their injuries and make false statements, make motorists pay more in CTP Insurance premiums with their motor registration.

Catching out people who make fraudulent claims saves South Australian motorists around $6 million a year. This equates to about $10 per year on CTP Insurance costs for every registered vehicle.

You may know of someone claiming to be injured, who is really just trying to rip off the system. If you do please report it by calling the Motor Injury Fraud Hotline on 1800 013 443.

You can remain anonymous.

Contact

Phone 1300 303 558

Fax 1300 617 531

Office hours
9:00 am to 5:00 pm,
Monday to Friday

Location
Level 8, Wakefield House,
30 Wakefield Street,
Adelaide SA 5000

Postal Address
GPO Box 1095, Adelaide SA 5001

Email ctp@sa.gov.au

ABN 44 509 445 953